Visualization of hepatitis E virus (HEV) in the human liver
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1 Visualization of hepatitis E virus (HEV) in the human liver Daniela Lenggenhager* 1, Jérôme Gouttenoire* 2, Mohsen Malehmir 1, Marion Bawohl 1, Hanna Honcharova-Biletska 1, Susanne Kreutzer 1, David Semela, Jörg Neuweiler, Sandra Hürlimann, Patrick Aepli, Montserrat Fraga, Roland Sahli, Luigi Terracciano, Laura Rubbia- Brandt, Beat Müllhaupt, Christine Sempoux 2, Darius Moradpour 2, Achim Weber 1 1 Department of Pathology and Molecular Pathology, University Hospital Zurich (USZ) and University Zurich (UZH) Switzerland 2 Centre hospitalier universitaire vaudois (CHUV), université de Lausanne (UNIL), Lausanne, Switzerland A conflict of interest was indicated by none of the authors. 29th European Congress of Pathology, Amsterdam achim.weber@usz.ch Department of Pathology and Molecular Pathology University Hospital Zurich (USZ) and University Zurich (UZH), Switzerland
2 Figatelli, Marché aux Fleurs, Nice, France Folienmaster USZ A4, DE
3 Background I Hepatitis E is a disease with global health burden Epidemic hepatitis E mostly acute, self-limiting hepatitis large epidemic outbreaks in ressource-poor countries water-born infection, mainly transmitted by contaminated drinking water Autochthonous hepatitis E mostly acute, self-limiting hepatitis zoonosis, transmitted mainly by contaminated food, in particular undercooked meat chronic course in immunocompromized individual possible broad differential diagnosis including drug-induced liver injury (DILI) Karmar et al (2008) NEJM Protzer... Weber (2015) Modern Pathology Chijioke... Weber (2015) Frontiers, Pathology Lenggenhager & Weber (2017) Gastroenterology Clinics of North America
4 Background II The hepatitis E virus (HEV) has three open reading frames (ORF) Hepatitis E virus (HEV) hepatotropic, positive-strand RNA virus 7.2 kb genome HEV open reading frames (ORF) ORF1 protein: non-structural protein responsible for viral replication ORF2 protein: a capsid protein ORF3 protein: a small phosphoprotein required for viral particle secretion Aggarwal et al. (2011) Hepatology Debing et al. (2016) Journal of Hepatology
5 Scientific questions, aim, and experimental approach of the study Visualization of HEV RNA and HEV proteins in human livers How is HEV temporally and spatially distributed in the liver during infection? Can this be exploited to develop diagnostic tools for daily practice? Experimental approach immunohistochemisty (IHC) panel of 12 antibodies against HEV ORF proteins 1-3 in situ hybridization (ISH) two different HEV probes (ACD) formalin-fixed, paraffin-embedded (FFPE) material of: HEV-protein expressing Huh7 cells HEV-replicating HEP293TT cells human liver tissues: 21 hepatitis E cases > 134 control cases
6 Results I HEV ORF 1, 2, and 3 protein all are detectable by IHC in FFPE Huh7 cells
7 Results II HEV ORF protein are detectable in FFPE HEV-replicating HEP293TT cells
8 Results III HEV ORF 2 protein is detectable by IHC in FFPE human liver tissues
9 Results IV HEV ORF 2 protein is detectable by IHC in FFPE human liver tissues
10 Results V Detection of HEV RNA (by ISH) correlates with detection of HEV ORF 2 protein (by IHC) in hepatocytes
11 Results VI HEV ORF 2 protein IHC is similarly sensitive to PCR testing
12 Summary, Conclusions: HEV ORF2 protein IHC increases the diagnostic accuracy and improves patient management HEV ORF2 protein can be reliably visualized in the liver of patients with hepatitis E, allowing for sensitive and specific detection of HEV in FFPE samples. A hitherto unknown nuclear localization of HEV ORF2 protein is described, suggesting an interaction with nuclear components. HEV ORF2 protein immunohistochemistry is a robust and reliable histopathologic tool for daily practive Lenggenhager*, Gouttenoire*... Weber (2017) Journal of Hepatology
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